ATYPICAL CHRONIC ACTIVE HERPESVIRUS INFECTIONS: ETIOLOGICAL STRUCTURE, FREQUENCY OF OCCURRENCE, CLINICAL SYNDROMES ASSOCIATED WITH THEM

Tatiana Suranova
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Abstract

Background: Every year, a steady, progressive increase in the number of atypical, chronic, active forms of infections caused by herpesviruses (AHA-HVI) is recorded. The diagnosis and selection of adequate therapeutic strategies for the treatment of these forms of infections presents significant difficulties for physicians of therapeutic, neurological profile, immunologists, infectious disease specialists, due to the polysyndromicity and the presence of many clinical masks of these infections. Aims: determining the prevalence of AHA-HVI among patients infected with herpes virus infections, as well as studying the features of the etiological structure and clinical manifestations/criterion signs of atypically occurring chronic forms of herpes viral infections. Materials and methods: Under our supervision at the Medsi CDC in Belorusskaya (Moscow) there were 98 patients (SG) of both sexes aged 23 to 60 years suffering from AHA-HVI. The comparison group consisted of 30 conditionally healthy subjects comparable in sex and age to SG patients. In addition to traditional methods (history collection, physical examination methods, CBC, etc.), serodiagnosis methods with ELISA were used to detect herpes-viral infections; PCR method for detecting the genome of viruses in biomaterials. The study was approved by the ethics committee, and all patients received informed consent to participate in the study. Statistical analysis was performed using adequate methods of statistic studies. Results: The study of the etiological structure of herpes virus infections in patients with AHA-HVI, mixed HVI was shown to occur in 83.4% of patients, and mono-HVI in 16.6% of cases. It was shown that EBV was the dominant virus among patients with both mono and mixed GVI. A high rate of EBV DNA detection was demonstrated in saliva (84.2%), posterior pharyngeal wall scraping (73.5%) and tonsils (42.9%), urine (12.6%) and blood (8.3%) is a marker of high replicative activity of the virus. The main clinical syndromes associated with the course of mono and mixed AHA-HVI were identified. Conclusions: Identification and quantitative assessment of the viral load associated with the severity of the course and severity of clinical manifestations of ACA-HVI, as well as clarification of the features of clinical manifestations and syndromes in patients suffering from various mono-, mixed-herpesvirus infections, allow us to outline goals for the further development of an adequate diagnostic algorithm for these atypical forms of herpesvirus infections and the concept of targeted, personalized etio- and immunopathogenetic therapy.
非典型慢性活动性疱疹病毒感染:病因结构、发生频率、与之相关的临床综合征
背景:每年,由疱疹病毒(AHA-HVI)引起的非典型、慢性、活动性感染的数量稳步、渐进地增加。诊断和选择适当的治疗策略来治疗这些形式的感染,给治疗医生、神经学专家、免疫学家、传染病专家带来了很大的困难,因为这些感染有多种症状,而且存在许多临床症状。目的:了解ha - hvi在疱疹病毒感染患者中的患病率,研究非典型发生的慢性疱疹病毒感染的病因结构和临床表现/判据特征。材料和方法:在我们在Belorusskaya (Moscow) Medsi CDC的监督下,有98例男女患者(SG),年龄在23至60岁之间。对照组由30名在性别和年龄上与SG患者相当的条件健康受试者组成。除传统方法(病史收集、体格检查、CBC等)外,采用ELISA血清诊断方法检测疱疹病毒感染;生物材料中病毒基因组的PCR检测方法。该研究得到了伦理委员会的批准,所有患者都收到了参与研究的知情同意书。采用适当的统计研究方法进行统计分析。结果:研究了ha -HVI患者疱疹病毒感染的病因结构,发现混合型HVI患者占83.4%,单型HVI患者占16.6%。结果表明,EBV在单一和混合GVI患者中均为优势病毒。唾液(84.2%)、咽后壁刮痕(73.5%)、扁桃体(42.9%)、尿液(12.6%)和血液(8.3%)是病毒高复制活性的标志,EBV DNA检出率较高。确定了与单一和混合AHA-HVI病程相关的主要临床综合征。结论:鉴定和定量评估与ACA-HVI病程严重程度和临床表现严重程度相关的病毒载量,以及澄清各种单一、混合疱疹病毒感染患者的临床表现和综合征特征,使我们能够概述进一步开发针对这些非典型疱疹病毒感染的适当诊断算法的目标。个性化的病因和免疫病理治疗。
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